Theoretical advantages exist for both block and nonblock scheduling. Facilities with enough space and staff may be able to schedule cases on the basis of patient and surgeon convenience, but that doesn’t work for facilities with less flexibility. At our facility, problems associated with first-come, first-served booking led to an…

Read More

High reliability has now permeated the healthcare literature, but some clinicians are still unsure exactly what it means. A simple definition offered by Coleen Smith, MBA, RN, CPHQ, director of High Reliability Initiatives for the Joint Commission Center for Transforming Healthcare, is “excellence in patient care for every patient, every…

Read More

Editor's Note Implementation of a surgical safety checklist was associated with a statistically significant 27% reduction in 90-day all cause postoperative mortality, while 30-day mortality remained unchanged in this study. The checklist was also associated with a reduction in length of stay but not 30-day readmission rates. This is the…

Read More

Editor's Note Two home visits by a physician assistant (PA) in the week after discharge significantly reduced the chance that a cardiac surgery patient would be readmitted, finds this study presented January 26 at the annual meeting of the Society of Thoracic Surgeons. Of 1,185 patients analyzed, those who received…

Read More

Emergencies such as the one described above don’t happen frequently in the OR, but it is important to prepare for them, and simulation has emerged as an ideal educational tool. This scenario took place in a simulation lab, not a real OR, so the danger to the “patient” (manikin) consisted…

Read More

Editor's Note This large-scale initiative, led by researchers from the Harvard School of Public Health, Boston, to implement surgical safety checklists in 13 South Carolina hospitals was associated with improved staff perceptions of perioperative safety. Included were improved staff perceptions of: mutual respect clinical leadership assertiveness on behalf of safety…

Read More

Editor's Note Select hospital characteristics are associated with readmissions after major surgical procedures, this study finds. After adjusting for patient factors, rural location was predictive of readmission after colectomy. Low-volume and minority-serving hospitals were associated with greater odds of readmission after total joint arthroplasties. Because financial penalties may worsen performance…

Read More

Editor's Note Participation in the American College of Surgeons, National Surgical Quality Improvement Program (ACS NSQIP) is associated with a reduction in postoperative adverse events, and the magnitude of quality improvement increases with time in the program, this study finds. Hospitals in the ACS NSQIP program for at least 3…

Read More

Editor's Note Enhanced recovery after surgery (ERAS) programs have led to reduction in length of stay and improved outcomes. This study finds that investment in an ERAS program also leads to financial savings. Despite positive results from international ERAS programs, the US has been slow to adopt such programs, in…

Read More

Editor's Note The new Josie Robertson Surgery Center, opened by Memorial Sloan Kettering (New York City), is a first-of-its-kind facility that allows cancer patients to go home within a day of significant surgical procedures. The surgery center has 12 ORs and can accommodate 60 surgical procedures per day. Surgeons, anesthesiologists,…

Read More